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Visual Speech Perception in Children WithLanguage Learning ImpairmentsVictoria C. P. Knowland,a Sam Evans,b Caroline Snell,a and Stuart RosenbPurpose: The purpose of the study was to assess the abilityof children with developmental language learning impairments(LLIs) to use visual speech cues from the talking face.Method: In this cross-sectional study, 41 typically developingchildren (mean age: 8 years 0 months, range: 4 years 5 monthsto 11 years 10 months) and 27 children with diagnosed LLI(mean age: 8 years 10 months, range: 5 years 2 months to11 years 6 months) completed a silent speechreading taskand a speech-in-noise task with and without visual supportfrom the talking face. The speech-in-noise task involved theidentification of a target word in a carrier sentence with asingle competing speaker as a masker.Results: Children in the LLI group showed a deficit inspeechreading when compared with their typically developingpeers. Beyond the single-word level, this deficit became moreapparent in older children. On the speech-in-noise task, asubstantial benefit of visual cues was found regardless ofage or group membership, although the LLI group showedan overall developmental delay in speech perception.Conclusion: Although children with LLI were less accuratethan their peers on the speechreading and speech-in noisetasks,both groups were able to make equivalent use ofvisual cues to boost performance accuracy when listeningin noise.Children with developmental language learningimpairments show a primary deficit in the acquisitionand use of oral language that cannot beexplained with recourse to sensory impairments, reducedopportunity to learn, or low nonverbal IQ. These childrenare variously referred to in the literature as having specificlanguage impairment or language learning difficulties.Here we use the term language learning impairment (LLI;Tallal & Benasich, 2002) to reflect a primary deficit in thelanguage domain while acknowledging the considerabledifficulties recorded across multiple areas of cognitive development(e.g., Donlan, Cowan, Newton, & Lloyd, 2007;Henry, Messer, & Nash, 2012; Hill, 2001).There is substantial heterogeneity within the populationof children with LLI and, as yet, little understandingof the developmental pathways causally related to atypicallanguage behavior. One fruitful, though controversial,area of research has been that of auditory processing. Asa group, children with LLI show poor performance incomparison to their typically developing (TD) peers onmultiple auditory processing tasks using both speech andnonspeech stimuli (Corriveau, Pasquini, & Goswami, 2007;McArthur & Bishop, 2004; Rosen, Adlard, & van derLely, 2009; Wright et al., 1997; and see Rosen, 2003, fora review). Within the speech domain, children with LLI andespecially those with mixed expressive and receptive difficulties(Stark & Heinz, 1996a) show greater variability inthe placement of phonetic category boundaries (Burlingame,Sussman, Gillam, & Hay, 2005; Sussman, 1993) and areless accurate at identifying steady-state vowels than TDcontrols (Stark & Heinz, 1996b). Deficits are seen in speechtasks even when working memory demands, known to bean area of weakness in children with LLI (Henry et al., 2012;Marton, 2008), are kept low.Although speech perception difficulties are evidentin children with LLI when tested in optimal listeningconditions, the effects of noise seem to exacerbate groupdifferences. This pattern has been observed for syllableidentification (Ziegler, Pech-Georgel, George, & Lorenzi,2011; Ziegler, Pech-Georgel, George, Alario, & Lorenzi,2005) and discrimination between minimal pairs (Vance& Martindale, 2012). In some cases, group effects haveonly been found under conditions of noise and not whengiven a clear auditory signal, for example, during phoneticcategorization (Robertson, Joanisse, Desroches, &Ng, 2009) and sentence perception (Bradlow, Kraus, &Hayes, 2003). Furthermore, the perception of speech innoise has been found to predict later receptive languageaCity University London, United KingdombUniversity College London, United KingdomCorrespondence to Victoria C. P. Knowland:victoria.knowland.1@city.ac.ukEditor: Jody KreimanAssociate Editor: Megha SundaraReceived September 29, 2014Revision received May 31, 2015Accepted July 30, 2015DOI: 10.1044/2015_JSLHR-S-14-0269Disclosure: The authors have declared that no competing interests existed at the timeof publication.Journal of Speech, Language, and Hearing Research • Vol. 59 • 1–14 • February 2016 • Copyright © 2016 American Speech-Language-Hearing Association 1Downloaded From: http://jslhr.pubs.asha.org/ by a University College London User on 03/04/2016Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspxscores for children with impairments (Robertson et al., 2009;Vance & Martindale, 2012; Ziegler et al., 2011).Behavioral studies of deficits in speec
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